MEDICARE: BENEVOLENT CAREGIVERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	3000346	IL

General Provider Information

NPI Number	:	1609170919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENEVOLENT CAREGIVERS, INC

Provider Business Mailing Address
First Line	:	8723 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1732
Country	:	US
Telephone Number	:	708-448-4068
Fax Number	:	708-443-4266

Provider Business Practice Location Address
First Line	:	8723 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1732
Country	:	US
Telephone Number	:	708-448-4068
Fax Number	:	708-443-4266

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ZAHRA L HUMECKI
Credential	:
Telephone Number	:	708-448-4068

Provider Enumeration Date	:	12/29/2010
Last Update Date	:	05/10/2016

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